Anastomotic device for tubular organ

ABSTRACT

Provided is an anastomotic device including a first holder and a second holder for holding a first anastomotic ring and a second anastomotic ring, respectively, a first slave body which is connected to the first holder, and which has a first slave surface, a second slave body which is connected to the second holder, and which has a second slave surface, a first driving body which has a first driving surface sliding along the first slave surface, and which moves along a predetermined direction, and a second driving body which has a second driving surface sliding along the second slave surface, and which moves along the predetermined direction. The first slave body moves toward the second slave body and the second slave body moves toward the first slave body by the movements of the first driving body and the second driving body.

TECHNICAL FIELD

The present invention disclosed herein relates to a device configured toperform an anastomosis on a tubular organ such as a blood vessel, andmore particularly, to an anastomotic device including anastomotic rings.

BACKGROUND ART

A free flap is used to reconstruct various parts of the body with absentsoft tissues, or for functional and aesthetic purposes. Following thefirst successful implementation of the free flap in 1973 by Daniel andTaylor, it has been significantly developed. The free flap is mainlyused in vascular anastomoses. However, vascular anastomoses using minutesutures require much time in mastering the suture technique as well aslong operation time. Moreover it carries the risk for thrombosis andtotal flap failure. To address these limitations, a vascular anastomosisusing a minute coupling ring was developed in 1962 by Komei Nakayama etal. Since Komei Nakayama et al first introduced a vascular anastomosisusing an anastomotic ring for reconstructing an oesophagus, manyexperimental and clinical works on mechanical anastomoses have beendeveloped.

The mechanical anastomoses have the following characteristics. First,the mechanical anastomosis is more accurate and requires less time inmastering the operation technique than a vascular anastomosis using asuture. Secondly, it takes just about 2 to 3 minutes to perform themechanical anastomosis. Thirdly, a monitoring result after themechanical anastomosis is not worse than the vascular anastomosis usinga suture. Fourthly, even when the diameter of a donor vessel issignificantly different from that of a recipient vessel, the differencethereof can be efficiently reduced. Fifthly, the mechanical anastomosiscan be efficiently performed even in a limited (small) space and a deeparea of a body.

DISCLOSURE Technical Problem

The present invention provides an anastomotic device that makes itpossible to efficiently and quickly perform an anastomosis on a tubularorgan such as a blood vessel.

The details of one or more embodiments are set forth in the accompanyingdrawings and the description below.

Technical Solution

Embodiments of the present invention provide anastomotic devicesincluding: a first holder and a second holder for holding a firstanastomotic ring and a second anastomotic ring, respectively; a firstslave body which is connected to the first holder, and which has a firstslave surface; a second slave body which is connected to the secondholder, and which has a second slave surface; a first driving body whichhas a first driving surface sliding along the first slave surface, andwhich moves along a predetermined direction; and a second driving bodywhich has a second driving surface sliding along the second slavesurface, and which moves along the predetermined direction, wherein thefirst slave body moves toward the second slave body and the second slavebody moves toward the first slave body by the movements of the firstdriving body and the second driving body.

In some embodiments, the first slave surface may include a first slaveinclination surface that is inclined outward to a front side of thefirst driving body, and a first slave plane that extends approximatelyin the predetermined direction from a front end of the first slaveinclination surface, and the first driving surface may include a firstdriving inclination surface that is inclined outward to the front sideof the first driving body, and a first driving plane that extendsapproximately in the predetermined direction from a rear end of thefirst driving inclination surface, wherein, when the first drivinginclination surface slides along the first slave inclination surface,the first salve body moves toward the second slave body.

In other embodiments, when the first driving plane slides along thefirst slave plane, the first slave body may be in a stop state.

In still other embodiments, the anastomotic devices may further include:a separation bar moving toward the first and second holders along thepredetermined direction in the stop state to separate the first andsecond anastomotic rings from the first and second holders; and a frontcase having a front end to which the separation bar and the first andsecond driving bodies are fixed, wherein, when the front case movesalong the predetermined direction, the separation bar and the first andsecond driving bodies move along the predetermined direction.

In even other embodiments, the anastomotic devices may further include:a separation bar moving toward the first and second holders along thepredetermined direction to separate the first and second anastomoticrings from the first and second holders; and a front case having a frontend to which the separation bar and the first and second driving bodiesare fixed, wherein, when the front case moves along the predetermineddirection, the separation bar and the first and second driving bodiesmove along the predetermined direction.

In yet other embodiments, the anastomotic devices may further include: amiddle case having a first thread on an inner circumferential surfacethereof; and a screw shaft which has a second thread on an outercircumferential surface thereof to correspond to the first thread, andwhich has a front end connected to the front case to move along thepredetermined direction by a rotation of the screw shaft.

In further embodiments, the anastomotic devices may further include: arear case disposed behind the front case; a pinion disposed inside therear case; a rotation lever connected to the pinion to rotate thepinion; and a rack member which has a front end holding the front caseto move together with the front case, and which includes a rack engagingwith the pinion and moving along the predetermined direction by arotation of the pinion.

In still further embodiments, the anastomotic devices may furtherinclude a first rotator that includes a first guide recess connected tothe first holder and extending in a direction approximatelyperpendicular to the predetermined direction, wherein the first holderincludes a first protrusion that is inserted in the first guide recessand moves along the first guide recess.

In even further embodiments, the anastomotic devices may furtherinclude: a first rotator connected to the first holder; a driving shaftincluding a driving gear and having a front end to which the firstrotator is fixed; a second rotator connected to the second holder; and aslave shaft which includes a driven gear engaging with the driving gearto rotate, and which has a front end to which the second rotator isfixed; wherein the first holder rotates toward the second holder and thesecond holder rotates toward the first holder by a rotation of thedriving shaft.

In yet further embodiments, the anastomotic devices may further include:a first rotator connected to the first holder; a first driving shaftincluding a first driving gear and a first driven gear and having afront end to which the first rotator is fixed; a second rotatorconnected to the second holder; a slave shaft which includes a seconddriven gear engaging with the first driving gear to rotate, and whichhas a front end to which the second rotator is fixed; and a seconddriving shaft including a second driving gear engaging with the firstdriven gear to rotate, wherein the first holder rotates toward thesecond holder and the second holder rotates toward the first holder bythe rotation of the second driving shaft.

In much further embodiments, the first driven gear may include a ringgear, and the second driving gear may include a pinion engaging with aninner part of the ring gear. In addition, the second driving shaft maybe disposed between the first driving shaft and the slave shaft.

In still much further embodiments, the anastomotic devices may furtherinclude a first rotator that includes a first front guide recess and afirst rear guide recess, wherein the first front guide recess isconnected to the first holder and extends in a direction approximatelyperpendicular to the predetermined direction, the first rear guiderecess is connected to the first slave body and extends in the directionapproximately perpendicular to the predetermined direction, the firstholder includes a first front protrusion that is inserted in the firstfront guide recess to move along the first front guide recess, and thefirst slave body includes a first rear protrusion that is inserted inthe first rear guide recess to move along the first rear guide recess.

In yet much further embodiments, the anastomotic devices may furtherinclude: a first front elastic body inserted in the first front guiderecess to apply elastic force to the first holder such that first holderreturns from the second holder; and a first rear elastic body insertedin the first rear guide recess to apply elastic force to the first slavebody such that first slave body returns from the second slave body.

Advantageous Effects

According to the embodiments of the present invention, an anastomosiscan be efficiently and quickly performed on a tubular organ such as ablood vessel.

DESCRIPTION OF DRAWINGS

The accompanying drawings are included to provide a furtherunderstanding of the present invention, and are incorporated in andconstitute a part of this specification. The drawings illustrateexemplary embodiments of the present invention and, together with thedescription, serve to explain principles of the present invention. Inthe drawings:

FIG. 1 is a perspective view illustrating an anastomotic deviceaccording to an embodiment of the present invention;

FIG. 2 is a perspective view illustrating the anastomotic device of FIG.1, without a front case, a middle case, and a rear case;

FIGS. 3 through 6 are schematic views illustrating rotations of firstand second holders according to rotations of a driving shaft and a slaveshaft, illustrated in FIG. 2;

FIGS. 7 and 8 are cross-sectional views illustrating a movement of thefront case according to a rotation of the rear case of FIG. 1;

FIGS. 9A, 9B and 9C are schematic views sequentially illustratingmovements of first and second slave bodies according to movements of thefront case and first and second driving bodies of FIG. 1;

FIG. 10 is a schematic view illustrating a state where anastomotic ringsare separated according to movements of the front case and a separationbar of FIG. 1;

FIGS. 11 through 13 are schematic views illustrating movements of afront case and a rack member according to a rotation of a pinionaccording to an embodiment of the present invention;

FIG. 14 is a perspective view illustrating a state where the anastomoticring of FIG. 1 is installed on a blood vessel;

FIG. 15 is a perspective view illustrating an anastomosis method usingthe anastomotic rings of FIG. 1;

FIG. 16 is a perspective view illustrating an anastomotic deviceaccording to an embodiment of the present invention;

FIG. 17 is a perspective view illustrating the anastomotic device ofFIG. 16, without a front case, a middle case, and a rear case;

FIG. 18 is a schematic view illustrating connections of first and seconddriving gears and first and second driven gears as illustrated in FIG.16;

FIGS. 19 through 22 are schematic views illustrating rotations of firstand second holders according to rotations of a driving shaft and a slaveshaft, illustrated in FIG. 17;

FIGS. 23 and 24 are cross-sectional views illustrating a movement of thefront case according to a rotation of the rear case of FIG. 16;

FIGS. 25A, 25B and 25C are schematic views sequentially illustratingmovements of first and second slave bodies according to movements of thefront case and first and second driving bodies as illustrated in FIG.16;

FIG. 26 is a schematic view illustrating a state where the first holderand the first slave body return to their original positions by a firstelastic body according to an embodiment of the present invention; and

FIG. 27 is a schematic view illustrating a state where anastomotic ringsare separated according to movements of the front case and a separationbar of FIG. 16.

BEST MODE

Preferred embodiments of the present invention will be described belowin more detail with reference to FIGS. 1 through 15. The presentinvention may, however, be embodied in different forms and should not beconstructed as limited to the embodiments set forth herein. Rather,these embodiments are provided so that this disclosure will be thoroughand complete, and will fully convey the scope of the present inventionto those skilled in the art. In the drawings, the dimensions of elementsmay be exaggerated for clarity of illustration.

While blood vessels are exemplified in the following embodiments, itwill be understood by those skilled in the art that various changes inform and details may be made therein without departing from the spiritand scope of the present invention. In addition, the present inventionmay be applied to various types of minute surgeries such as areconstruction using a free flap method, an anastomosis of a cut bloodvessel, an intestinal anastomosis, a treatment of a heart disease, andother anastomoses of tubular organs.

FIG. 1 is a perspective view illustrating an anastomotic deviceaccording to an embodiment of the present invention. FIG. 2 is aperspective view illustrating the anastomotic device of FIG. 1, withouta front case, a middle case, and a rear case. Referring to FIGS. 1 and2, the anastomotic device includes a first holder 60 and a second holder70. The first and second holders 60 and 70 have an approximately Ushape, and are connected to a first rotator 20 and a second rotator 30,respectively, to fix anastomotic rings 40 and 40′ during a medicaltreatment. After the medical treatment, the anastomotic rings 40 and 40′are removed from the first and second holders 60 and 70. A first slavebody 62 and a second slave body 72 are disposed at the rear ends of thefirst and second holders 60 and 70, respectively. The first and secondslave bodies 62 and 72 move according to movements of a first drivingbody 80 and a second driving body 90, and a moving direction of thefirst and second driving bodies 80 and 90 is approximately perpendicularto that of the first and second slave bodies 62 and 72, which will bedescribed later.

Referring to FIG. 2, the first slave body 62 has a first slave surfacecontacting the first driving body 80 to be described later. The firstslave surface includes a first slave inclination surface 62 a and afirst slave plane 62 b. The first slave inclination surface 62 a isinclined outward to the front side of the first driving body 80, and thefirst slave plane 62 b extends approximately in the moving direction ofthe first driving body 80 from the front end of the first slaveinclination surface 62 a. In a same manner, the second slave body 72 hasa second slave surface contacting the second driving body 90 to bedescribed later. The second slave surface includes a second slaveinclination surface 72 a and a second slave plane 72 b. The second slaveinclination surface 72 a is inclined outward to the front side of thesecond driving body 90, and the second slave plane 72 b extendsapproximately in the moving direction of the second driving body 90 fromthe front end of the second slave inclination surface 72 a. The firstand second slave surfaces will be described later in detail.

As illustrated in FIG. 2, the first and second rotators 20 and 30 aredisposed at the front end of a driving shaft 22 and the front end of aslave shaft 32, respectively. The driving shaft 22 and the first rotator20 rotate together. The slave shaft 32 and the second rotator 30 rotatetogether. A clip C includes pins that are inserted in rotation centersof the first and second rotators 20 and 30, respectively. The pinsprevent the movement of the first and second rotators 20 and 30 whilethe first and second rotators 20 and 30 rotate. The first and secondrotators 20 and 30 rotate about the pins inserted in the rotationcenters thereof.

The first and second rotators 20 and 30 include a first guide recess 20a and a second guide recess 30 a, respectively. The first and secondguide recesses 20 a and 30 a extend approximately in the movingdirection of the first and second slave bodies 62 and 72. The firstholder 60 includes a first protrusion 61, which is inserted in the firstguide recess 20 a and moves along the first guide recess 20 a. Accordingto a movement of the first slave body 62, the protrusion 61 movestogether with the first holder 60 along the first guide recess 20 a. Ina same manner, the second holder 70 includes a second protrusion (notshown) that moves along the second guide recess 30 a. That is, accordingto a movement of the second slave body 72, the second protrusion movestogether with the second holder 70 along the second guide recess 30 a.Accordingly, the anastomotic rings 40 and 40′ fixed to the first andsecond holders 60 and 70 are coupled to each other, which will bedescribed later.

The driving shaft 22 and the slave shaft 32 pass through a fixing member13. A driving gear 24 is installed on the driving shaft 22. A drivengear 34 is installed on the slave shaft 32. The driving gear 24 rotatestogether with the driving shaft 22, and the driven gear 34 rotatestogether with the slave shaft 32. The driven gear 34 engages with thedriving gear 24 and rotates according to a rotation of the driving gear24. A driving lever L1 is disposed at the rear end of the driving shaft22. The driving shaft 22 and the slave shaft 32 will be described laterin detail.

Referring to FIG. 1, the anastomotic device includes a front case 12, amiddle case 14, a rear case 16, and a screw shaft 18. The first andsecond driving bodies 80 and 90 and a separation bar 50 are fixed to thefront end of the front case 12, and the middle case 14 is disposedbetween the front case 12 and the rear case 16. The driving shaft 22 andthe slave shaft 32 are exposed out of the front case 12 through thefront end of the front case 12. The first and second holders 60 and 70,and the first and second rotators 20 and 30 are disposed at the frontside of the front case 12. The driving lever L1 is exposed out of therear case 16 through the rear end of the rear case 16. The front case12, the middle case 14, and the rear case 16 may have an approximatelycircular or polygonal cylinder shape.

FIGS. 3 through 6 are schematic views illustrating rotations of thefirst and second holders according to rotations of the driving shaft andthe slave shaft, illustrated in FIG. 2. In the state where the drivinggear 24 engages with the driven gear 34 as illustrated in FIG. 2, whenthe driving lever L1 connected to the rear end of the driving shaft 22is rotated clockwise, the driving gear 24 rotates to rotate the drivengear 34 counterclockwise, and thus, the slave shaft 32 rotatescounterclockwise.

In the state where the anastomotic rings 40 and 40′ fixed respectivelyto the first and second holders 60 and 70 are disposed on approximatelythe same plane as illustrated in FIGS. 3 and 4, when the driving leverL1 is rotated, the first and second holders 60 and 70 rotate. Accordingto the rotation of the first rotator 20, the anastomotic ring 40 fixedto the first holder 60 is rotated counterclockwise to the second holder70. According to the rotation of the second rotator 30, the anastomoticring 40′ fixed to the second holder 70 is rotated clockwise to the firstholder 60. Referring to FIGS. 5 and 6, according to the rotations of thefirst and second holders 60 and 70, the anastomotic rings 40 and 40′fixed to the first and second holders 60 and 70 face each other.

FIGS. 7 and 8 are cross-sectional views illustrating a movement of thefront case according to a rotation of the rear case of FIG. 1. Referringto FIG. 7, the front end of the screw shaft 18 is connected to the rearend of the front case 12. The screw shaft 18 freely rotates at the rearend of the front case 12, and torque of the screw shaft 18 is nottransmitted to the front case 12. However, when the screw shaft 18 movesforward or rearward, the front case 12 connected to the screw shaft 18is moved forward or rearward together with the screw shaft 18, whichwill be described later. The rear end of the screw shaft 18 is connectedto the front end of the rear case 16. When the rear case 16 rotates, thescrew shaft 18 rotates together with the rear case 16.

The screw shaft 18 passes through the middle case 14. An outercircumferential surface of the screw shaft 18 is provided with a thread.An inner circumferential surface of the middle case 14 is also providedwith a thread. The thread of the middle case 14 engages with the threadof the screw shaft 18.

Referring to FIG. 8, when the rear case 16 rotates in a predetermineddirection, the thread of the screw shaft 18 moves along the thread ofthe middle case 14, and the screw shaft 18 moves forward. According tothe forward movement of the screw shaft 18, the front case 12 also movesforward. On the contrary, when the screw shaft 18 rotates in theopposite direction to the predetermined direction, the thread of thescrew shaft 18 moves along the thread of the middle case 14, and thescrew shaft 18 moves rearward. According to the rear movement of thescrew shaft 18, the front case 12 also moves rearward.

FIGS. 9A, 9B and 9C are schematic views sequentially illustratingmovements of the first and second slave bodies according to movements ofthe front case and the first and second driving bodies of FIG. 1. FIG.10 is a schematic view illustrating a state where the anastomotic ringsare separated according to movements of the front case and theseparation bar of FIG. 1.

As described above, the separation bar 50 and the first and seconddriving bodies 80 and 90, fixed to the front end of the front case 12,move together with the front case 12. Referring to FIG. 9A, as the frontcase 12 moves forward, a first driving inclination surface 82 of thefirst driving body 80 contacts the first slave inclination surface 62 aof the first slave body 62, and a second driving inclination surface 92of the second driving body 90 contacts the second slave inclinationsurface 72 a of the second slave body 72.

In this state, when the front case 12 moves forward, the first drivinginclination surface 82 moves along the first slave inclination surface62 a to apply force to the first slave inclination surface 62 a, andthus, the first slave body 62 moves to the second slave body 72. In asame manner, the second driving inclination surface 92 moves along thesecond slave inclination surface 72 a to apply force to the second slaveinclination surface 72 a, and thus, the second slave body 72 moves tothe first slave body 62. Accordingly, as illustrated in FIGS. 9B and 9C,the first and second slave bodies 62 and 72 come close to each other,and the first and second holders 60 and 70 also come close to eachother, together with the first and second slave bodies 62 and 72. Themoving direction of the first and second slave bodies 62 and 72 isapproximately perpendicular to the forward moving direction of the frontcase 12.

The first protrusion 61 of the first holder 60 and the second protrusionof the second holder 70 move along the first and second guide recesses20 a and 30 a, respectively. Accordingly, the anastomotic rings 40 and40′ come close to each other and are coupled to each other.

When the anastomotic rings 40 and 40′ fixed to the first and secondholders 60 and 70 are coupled to each other, the first and seconddriving inclination surfaces 82 and 92 are removed from the first andsecond slave inclination surfaces 62 a and 72 a, and the first andsecond driving inclination surfaces 82 and 92 do not apply force to thefirst and second slave inclination surfaces 62 a and 72 a any more.After that, as illustrated in FIG. 9C, as the front case 12 movesforward, a first driving plane 84 and a second driving plane 94 movealong the first and second slave planes 62 b and 72 b.

After that, as illustrated in FIG. 10, the separation bar 50 movesforward together with the front case 12, and the separation bar 50 passthrough a space disposed between the first and second holders 60 and 70to push out the anastomotic rings 40 and 40′ from the first and secondholders 60 and 70. Thus, the anastomotic rings 40 and 40′ are removedfrom the first and second holders 60 and 70.

FIGS. 11 through 13 are schematic views illustrating movements of afront case and a rack member according to a rotation of a pinionaccording to an embodiment of the present invention. Unlike theabove-described anastomotic device of FIGS. 7 and 8, a rack member 18 isdisposed at the rear end of the front case 12 and includes a rack. Apinion 17 is disposed within the rear case 16 and engages with the rackof the rack member 18. The pinion 17 is connected to a rotation lever 19disposed outside the rear case 16. When the rotation lever 19 rotates,the pinion 17 rotates together with the rotation lever 19.

Referring to FIG. 11, in the state where the rear end of the front case12 contacts the front end of the rear case 16, when the rotation lever19 is rotated, the pinion 17 is rotated together with the rotation lever19. Referring to FIG. 13, as the pinion 17 rotates, the rack member 18moves forward, and the front case 12 also moves forward together withthe rack member 18.

FIG. 14 is a perspective view illustrating the anastomotic ring 40installed on a blood vessel according to an embodiment of the presentinvention. FIG. 15 is a perspective view illustrating an anastomosismethod using the anastomotic rings 40 and 40′ according to an embodimentof the present invention. Referring to FIG. 14, the anastomotic ring 40is installed on the end of a cut blood vessel, and the blood vessel isfitted on fixing pins 44 provided to the anastomotic ring 40 to preventthe removal of the blood vessel from the anastomotic ring 40 andfacilitate the coupling of intimae.

Referring to FIG. 15, the fixing pins 44 installed on the anastomoticring 40 are coupled to coupling recesses formed in the anastomotic ring40′, and fixing pins 44′ installed on the anastomotic ring 40′ arecoupled to coupling recesses formed in the anastomotic ring 40, therebyimproving the coupling of the anastomotic rings 40 and 40′. Theanastomotic rings 40 and 40′ are installed on two blood vessels,respectively, and the anastomotic rings 40 and 40′ are coupled to eachother, thereby connecting the blood vessels to each other.

Preferred embodiments of the present invention will be described belowin more detail with reference to FIGS. 16 through 27. The presentinvention may, however, be embodied in different forms and should not beconstructed as limited to the embodiments set forth herein. Rather,these embodiments are provided so that this disclosure will be thoroughand complete, and will fully convey the scope of the present inventionto those skilled in the art. In the drawings, the dimensions of elementsmay be exaggerated for clarity of illustration.

FIG. 16 is a perspective view illustrating an anastomotic deviceaccording to an embodiment of the present invention. FIG. 17 is aperspective view illustrating the anastomotic device of FIG. 16, withouta front case, a middle case, and a rear case. Referring to FIGS. 16 and17, the anastomotic device includes a first holder 160 and a secondholder 170. The first and second holders 160 and 170 have anapproximately U shape, and are connected to a first rotator 120 and asecond rotator 130, respectively, to fix the anastomotic rings 40 and40′ during a medical treatment. After the medical treatment, theanastomotic rings 40 and 40′ are removed from the first and secondholders 160 and 170. A first slave body 162 and a second slave body 172are disposed at the rear ends of the first and second holders 160 and170, respectively. The first and second slave bodies 162 and 172 moveaccording to movements of a first driving body 180 and a second drivingbody 190, and a moving direction of the first and second driving bodies180 and 190 is approximately perpendicular to that of the first andsecond slave bodies 162 and 172, which will be described later.

Referring to FIG. 17, the first slave body 162 has a first slave surfacecontacting the first driving body 180 to be described later. The firstslave surface includes a first slave inclination surface 162 a and afirst slave plane 162 b. The first slave inclination surface 162 a isinclined outward to the front side of the first driving body 180, andthe first slave plane 162 b extends approximately in the movingdirection of the first driving body 180 from the front end of the firstslave inclination surface 162 a. In a same manner, the second slave body172 has a second slave surface contacting the second driving body 190 tobe described later. The second slave surface includes a second slaveinclination surface 172 a and a second slave plane 172 b. The secondslave inclination surface 172 a is inclined outward to the front side ofthe second driving body 190, and the second slave plane 172 b extendsapproximately in the moving direction of the second driving body 190from the front end of the second slave inclination surface 172 a. Thefirst and second slave surfaces will be described later in detail.

As illustrated in FIG. 17, the first and second rotators 120 and 130 aredisposed at the front end of a first driving shaft 122 and the front endof a slave shaft 132, respectively. The first driving shaft 122 and thefirst rotator 120 rotate together. The slave shaft 132 and the secondrotator 130 rotate together. The clip C includes pins that are insertedin rotation centers of the first and second rotators 120 and 130,respectively. The pins prevent the movement of the first and secondrotators 120 and 130 while the first and second rotators 120 and 130rotate. The first and second rotators 120 and 130 rotate about the pinsinserted in the rotation centers thereof.

The first and second rotators 120 and 130 include first guide recessesand second guide recesses. The first and second guide recesses extendapproximately in the moving direction of the first and second slavebodies 162 and 172. The first guide recesses include a first front guiderecess 120 a and a first rear guide recess 120 b. The second guiderecesses include a second front guide recess 130 a and a second rearguide recess 130 b. The first holder 160 includes a first frontprotrusion 161 that is inserted in the first front guide recess 120 a.The first slave body 162 includes a first rear protrusion 163 that isinserted in the first rear guide recess 120 b. The first frontprotrusion 161 and the first rear protrusion 163 move along the firstfront guide recess 120 a and the first rear guide recess 120 b,respectively. According to a movement of the first slave body 162, thefirst front protrusion 161 and the first rear protrusion 163 movetogether with the first holder 160 and the first slave body 162 alongthe first front guide recess 120 a and the first rear guide recess 120b. In a same manner, the second holder 170 and the second slave body 172include a second front protrusion (not shown) and a second rearprotrusion (not shown), respectively. The second front protrusion andthe second rear protrusion move along the second front guide recess 130a and the second rear guide recess 130 b, respectively. That is,according to a movement of the second slave body 172, the second frontprotrusion and the second rear protrusion move together with the secondholder 170 and the second slave body 172 along the second front guiderecess 130 a and the second rear guide recess 130 b. Accordingly, theanastomotic rings 40 and 40′ fixed to the first and second holders 160and 170 are coupled to each other, which will be described later.

The first driving shaft 122 and the slave shaft 132 pass through afixing member 113. A first driving gear 124 is installed on the firstdriving shaft 122. A second driven gear 134 is installed on the slaveshaft 132. The first driving gear 124 rotates together with the firstdriving shaft 122, and the second driven gear 134 rotates together withthe slave shaft 132. The second driven gear 134 engages with the firstdriving gear 124 and rotates according to a rotation of the firstdriving gear 124.

A first driven gear 126 is installed at the rear end of the firstdriving shaft 122, and rotates together with the first driving shaft122. The first driven gear 126 is a ring gear (or an internal gear). Asecond driving gear 129, which functions as a pinion, is disposed insidethe first driven gear 126. The first driven gear 126 rotates accordingto a rotation of the second driving gear 129, and the first drivingshaft 122 rotates according to the rotation of the first driven gear126. Accordingly, the first driving gear 124 rotates.

The second driving gear 129 is fixed to the front end of a seconddriving shaft 128, and rotates together with the second driving shaft128. FIG. 18 is a schematic view illustrating connections of the firstand second driving gears 124 and 129 and the first and second drivengears 126 and 134 as illustrated in FIG. 17. Referring to FIG. 18, thesecond driving shaft 128 is disposed between the first driving shaft 122and the slave shaft 132. Referring to FIG. 16, the second driving shaft128 is rotatably installed on a rear case 116. The second driving shaft128 is disposed at the central part of the rear case 116, and a drivinglever L2 is disposed at the rear end of the second driving shaft 128.The first driving shaft 122 and the slave shaft 132 will be describedlater in detail.

Referring to FIG. 16, the anastomotic device includes a front case 112,a middle case 114, the rear case 116, and a screw shaft 118. The firstand second driving bodies 180 and 190 and a separation bar 150 are fixedto the front end of the front case 112, and the middle case 114 isdisposed between the front case 112 and the rear case 116. The firstdriving shaft 122 and the slave shaft 132 are exposed out of the frontcase 112 through the front end of the front case 112. The first andsecond holders 160 and 170, and the first and second rotators 120 and130 are disposed at the front side of the front case 112. The drivinglever L2 is exposed out of the rear case 116 through the rear end of therear case 116. The front case 112, the middle case 114, the rear case116, and the screw shaft 118 may have an approximately circular orpolygonal cylinder shape.

FIGS. 18 through 20 are schematic views illustrating rotations of thefirst and second holders according to rotations of the first drivingshaft and the slave shaft illustrated in FIG. 17. In the state where thesecond driving gear 129 engages with the first driven gear 126 asillustrated in FIG. 18, when the driving lever L2 connected to the rearend of the second driving shaft 128 is rotated clockwise, the seconddriving gear 129 rotates to rotate the first driven gear 126 clockwise,and thus, the first driving gear 124 and the first driving shaft 122rotate clockwise. Thus, the second driven gear 134 rotatescounterclockwise, and the slave shaft 132 rotates counterclockwiseaccordingly.

In the state where the anastomotic rings 40 and 40′ fixed respectivelyto the first and second holders 160 and 170 are disposed onapproximately the same plane as illustrated in FIGS. 19 and 20, when thedriving lever L2 is rotated, the first and second holders 160 and 170rotate. According to the rotation of the first rotator 120, theanastomotic ring 40 fixed to the first holder 160 is rotatedcounterclockwise to the second holder 170. According to the rotation ofthe second rotator 130, the anastomotic ring 40′ fixed to the secondholder 170 is rotated clockwise to the first holder 160. Referring toFIGS. 21 and 22, according to the rotations of the first and secondholders 160 and 170, the anastomotic rings 40 and 40′ fixed to the firstand second holders 160 and 170 face each other.

At this point, rotational speed of the first driving shaft 122 androtational speed of the slave shaft 132 are proportional to that of thefirst driven gear 126. The rotational speed of the first driven gear 126can be adjusted according to a gear ratio (diameter ratio or ratio inthe numbers of teeth) of the first driven gear 126 to the second drivinggear 129.

Referring to FIGS. 20 and 22, since the first and second rotators 120and 130 engage with each other and have the same diameter, when thefirst and second rotators 120 and 130 rotate, the first and secondrotators 120 and 130 are approximately the same in rotationaldisplacement and rotational speed, and thus, can rotate stably.

FIGS. 23 and 24 are cross-sectional views illustrating a movement of thefront case according to a rotation of the rear case of FIG. 16.Referring to FIG. 23, the front end of the screw shaft 118 is connectedto the rear end of the front case 112. The screw shaft 118 freelyrotates at the rear end of the front case 112, and torque of the screwshaft 118 is not transmitted to the front case 112. However, when thescrew shaft 118 moves forward or rearward, the front case 112 connectedto the screw shaft 118 is moved forward or rearward together with thescrew shaft 118, which will be described later. The rear end of thescrew shaft 118 is connected to the front end of the rear case 116. Whenthe rear case 116 rotates, the screw shaft 118 rotates together with therear case 116.

The screw shaft 118 passes through the middle case 114. An outercircumferential surface of the screw shaft 118 is provided with athread. An inner circumferential surface of the middle case 114 is alsoprovided with a thread. The thread of the middle case 114 engages withthe thread of the screw shaft 118.

Referring to FIG. 24, when the rear case 116 rotates in a predetermineddirection, the thread of the screw shaft 118 moves along the thread ofthe middle case 114, and the screw shaft 118 moves forward. According tothe forward movement of the screw shaft 118, the front case 112 alsomoves forward. On the contrary, when the screw shaft 118 rotates in theopposite direction to the predetermined direction, the thread of thescrew shaft 118 moves along the thread of the middle case 114, and thescrew shaft 118 moves rearward. According to the rear movement of thescrew shaft 118, the front case 112 also moves rearward.

FIGS. 25A, 25B and 25C are schematic views sequentially illustratingmovements of the first and second slave bodies according to movements ofthe front case and the first and second driving bodies as illustrated inFIG. 16. FIG. 26 is a schematic view illustrating a state where thefirst holder and the first slave body return to their original positionsby a first elastic body according to an embodiment of the presentinvention.

As described above, the separation bar 150 and the first and seconddriving bodies 180 and 190, fixed to the front end of the front case112, move together with the front case 112. Referring to FIG. 25A, asthe front case 112 moves forward, a first driving inclination surface182 of the first driving body 180 contacts the first slave inclinationsurface 162 a of the first slave body 162, and a second drivinginclination surface 192 of the second driving body 190 contacts thesecond slave inclination surface 172 a of the second slave body 172.

In this state, when the front case 112 moves forward, the first drivinginclination surface 182 moves along the first slave inclination surface162 a to apply force to the first slave inclination surface 162 a, andthus, the first slave body 162 moves to the second slave body 172. In asame manner, the second driving inclination surface 192 moves along thesecond slave inclination surface 172 a to apply force to the secondslave inclination surface 172 a, and thus, the second slave body 172moves to the first slave body 162. Accordingly, as illustrated in FIGS.25B and 25C, the first and second slave bodies 162 and 172 come close toeach other, and the first and second holders 160 and 170 also come closeto each other, together with the first and second slave bodies 162 and172. The moving direction of the first and second slave bodies 162 and172 is approximately perpendicular to the forward moving direction ofthe front case 112.

The first protrusion 161 of the first holder 160 and the first rearprotrusion 163 of the first slave body 162 move along the first frontguide recess 120 a and the first rear guide recess 120 b. Accordingly,the anastomotic rings 40 and 40′ come close to each other and arecoupled to each other. Referring to FIG. 26, a first front elastic body161 a and a first rear elastic body 161 b are disposed within the firstfront guide recess 120 a and the first rear guide recess 120 b, andapply elastic force to the first front protrusion 161 and the first rearprotrusion 163. Thus, when the first driving body 180 is moved rearwardaccording to the rear movement of the front case 112, the first holder160 and the first slave body 162 return to the original positionsthereof by the elastic force. This mechanism can be applied to thesecond holder 170 and the second slave body 172 in a same manner.

FIG. 27 is a schematic view illustrating a state where the anastomoticrings are separated according to movements of the front case and theseparation bar of FIG. 16. When the anastomotic rings 40 and 40′ fixedto the first and second holders 160 and 170 are coupled to each other,the first and second driving inclination surfaces 182 and 192 areremoved from the first and second slave inclination surfaces 162 a and172 a, and the first and second driving inclination surfaces 182 and 192do not apply force to the first and second slave inclination surfaces162 a and 172 a any more. After that, as illustrated in FIG. 25C, as thefront case 112 moves forward, a first driving plane 184 and a seconddriving plane 194 move along the first and second slave planes 162 b and172 b.

After that, as illustrated in FIG. 27, the separation bar 150 movesforward together with the front case 112, and the separation bar 150pass through a space disposed between the first and second holders 160and 170 to push out the anastomotic rings 40 and 40′ from the first andsecond holders 160 and 170. Thus, the anastomotic rings 40 and 40′ areremoved from the first and second holders 160 and 170.

The above-disclosed subject matter is to be considered illustrative, andnot restrictive, and the appended claims are intended to cover all suchmodifications, enhancements, and other embodiments, which fall withinthe true spirit and scope of the present invention. Thus, to the maximumextent allowed by law, the scope of the present invention is to bedetermined by the broadest permissible interpretation of the followingclaims and their equivalents, and shall not be restricted or limited bythe foregoing detailed description.

INDUSTRIAL APPLICABILITY

The present invention may be applied to various types of minutesurgeries such as a reconstruction using a free flap method, ananastomosis of a cut blood vessel, an intestinal anastomosis, atreatment of a heart disease, and other anastomoses of tubular organs.

The invention claimed is:
 1. An anastomotic device comprising: a firstholder and a second holder for holding a first anastomotic ring and asecond anastomotic ring, respectively; a first slave body connected tothe first holder and having a first slave surface; a second slave bodyconnected to the second holder and having a second slave surface; afirst driving body having a first driving surface sliding along thefirst slave surface, the first driving body moving along a predetermineddirection; a second driving body having a second driving surface slidingalong the second slave surface, the second driving body moving along thepredetermined direction, the first slave body moving toward the secondslave body and the second slave body moving toward the first slave bodyby the movements of the first driving body and the second driving body;a first rotator connected to the first holder; a second rotatorconnected to the second holder; a driving shaft including a driving gearand having a front end to which the first rotator is fixed; and a slaveshaft engaging with the driving gear to rotate and having a front end towhich the second rotator is fixed; wherein the first holder rotatestoward the second holder and the second holder rotates toward the firstholder by a rotation of the driving shaft.
 2. The anastomotic device ofclaim 1, wherein the first slave surface comprises a first slaveinclination surface that is inclined outward to a front side of thefirst driving body, and a first slave plane that extends approximatelyin the predetermined direction from a front end of the first slaveinclination surface, and the first driving surface comprises a firstdriving inclination surface that is inclined outward to the front sideof the first driving body, and a first driving plane that extendsapproximately in the predetermined direction from a rear end of thefirst driving inclination surface, wherein, when the first drivinginclination surface slides along the first slave inclination surface,the first salve body moves toward the second slave body.
 3. Theanastomotic device of claim 2, wherein, when the first driving planeslides along the first slave plane, the first slave body is in a stopstate.
 4. The anastomotic device of claim 3, further comprising: aseparation bar moving toward the first and second holders along thepredetermined direction in the stop state to separate the first andsecond anastomotic rings from the first and second holders; and a frontcase having a front end to which the separation bar and the first andsecond driving bodies are fixed, wherein, when the front case movesalong the predetermined direction, the separation bar and the first andsecond driving bodies move along the predetermined direction.
 5. Theanastomotic device of claim 1, further comprising: a separation barmoving toward the first and second holders along the predetermineddirection to separate the first and second anastomotic rings from thefirst and second holders; and a front case having a front end to whichthe separation bar and the first and second driving bodies are fixed,wherein, when the front case moves along the predetermined direction,the separation bar and the first and second driving bodies move alongthe predetermined direction.
 6. The anastomotic device of claim 5,further comprising: a middle case having a first thread on an innercircumferential surface thereof; and a screw shaft having a secondthread on an outer circumferential surface thereof to correspond to thefirst thread and having a front end connected to the front case to movealong the predetermined direction by a rotation of the screw shaft. 7.The anastomotic device of claim 5, further comprising: a rear casedisposed behind the front case; a pinion disposed inside the rear case;a rotation lever connected to the pinion to rotate the pinion; and arack member having a front end holding the front case to move togetherwith the front case and including a rack engaging with the pinion andmoving along the predetermined direction by a rotation of the pinion. 8.The anastomotic device of claim 1, wherein the first rotator includes afirst guide recess extending in a direction approximately perpendicularto the predetermined direction, and wherein the first holder includes afirst protrusion that is inserted in the first guide recess and movesalong the first guide recess.
 9. The anastomotic device of claim 1,wherein the first rotator includes a first front guide recess and afirst rear guide recess, the first front guide recess is connected tothe first holder and extends in a direction approximately perpendicularto the predetermined direction, the first rear guide recess is connectedto the first slave body and extends in the direction approximatelyperpendicular to the predetermined direction, the first holder includesa first front protrusion that is inserted in the first front guiderecess to move along the first front guide recess, and the first slavebody includes a first rear protrusion that is inserted in the first rearguide recess to move along the first rear guide recess.
 10. Theanastomotic device of claim 9, further comprising: a first front elasticbody inserted in the first front guide recess to apply elastic force tothe first holder such that first holder returns from the second holder;and a first rear elastic body inserted in the first rear guide recess toapply elastic force to the first slave body such that first slave bodyreturns from the second slave body.
 11. An anastomotic devicecomprising: a first holder and a second holder for holding a firstanastomotic ring and a second anastomotic ring, respectively; a firstslave body connected to the first holder and having a first slavesurface; a second slave body connected to the second holder and having asecond slave surface; a first driving body having a first drivingsurface sliding along the first slave surface, the first driving bodymoving along a predetermined direction; a second driving body having asecond driving surface sliding along the second slave surface, thesecond driving body moving along the predetermined direction, the firstslave body moving toward the second slave body and the second slave bodymoving toward the first slave body by the movements of the first drivingbody and the second driving body; a first rotator connected to the firstholder; a first driving shaft including a first driving gear and a firstdriven gear and having a front end to which the first rotator is fixed;a second rotator connected to the second holder; a slave shaft includinga second driven gear engaging with the first driving gear to rotate andhaving a front end to which the second rotator is fixed; and a seconddriving shaft including a second driving gear engaging with the firstdriven gear to rotate, wherein the first holder rotates toward thesecond holder and the second holder rotates toward the first holder bythe rotation of the second driving shaft.
 12. The anastomotic device ofclaim 11, wherein the first driven gear comprises a ring gear, and thesecond driving gear comprises a pinion engaging with an inner part ofthe ring gear.
 13. The anastomotic device of claim 11, wherein thesecond driving shaft is disposed between the first driving shaft and theslave shaft.
 14. The anastomotic device of claim 11, wherein the firstslave surface comprises a first slave inclination surface that isinclined outward to a front side of the first driving body and a firstslave plane that extends approximately in the predetermined directionfrom a front end of the first slave inclination surface, wherein thefirst driving surface comprises a first driving inclination surface thatis inclined outward to the front side of the first driving body, and afirst driving plane that extends approximately in the predetermineddirection from a rear end of the first driving inclination surface, andwherein, when the first driving inclination surface slides along thefirst slave inclination surface, the first salve body moves toward thesecond slave body.
 15. The anastomotic device of claim 14, wherein, whenthe first driving plane slides along the first slave plane, the firstslave body is in a stop state.